Adam Fein, with Drug Channels, recently posted an excellent analysis of the Kaiser/HRET 2016 Employer Health Benefits Survey. His analysis addresses, among other things, cost-shifting in the employer/commercial prescription insurance realm. See Employer Pharmacy Benefits in 2016: More Specialty Drug Cost-Shifting Means More Problems for Patients for his discussion. It is a worthwhile read. Often, the analysis of Drug Channels......
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Open Enrollment started Saturday, and we got our first look at how our customers’ medications will be priced in 2017 under Medicare Part D. There are several interesting observations to be made. Preferred, Non-Preferred, and Mail Order With the release of the 2017 data, we can actually calculate patient-cost and pharmacy reimbursement for one of the......
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The title above comes from the 1983 movie WarGames. The plot of this movie centers around a young computer hacker that manages to access a Department of Defense computer. That computer asks the hacker, Shall we play a game? That game just happens to be Global Thermonuclear War, and as it turned out, the game was actually very real. Sometimes, an apparently......
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The role of Pharmacy Benefit Managers, the PBMs, in the US healthcare system has been detailed on this blog several times. And each time, it seems, the public is able to better understand how detrimental some of theses practices are to our healthcare system. A few days ago, a blog post from Lexology entitled PBMs and Drug Pricing: Congress and Major......
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Back in in the 80’s, when I was in High School, I had to read the 1953 Arthur Miller play, The Crucible. The play title references a definition of the word crucible that, until I read the play, was unfamiliar to me. cru·ci·ble noun \ˈkrü-sə-bəl\ a difficult test or challenge That definition again came to mind this month as we started to prepare for......
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After the Thriving Pharmacist published its take on Mail Order Narcotics, Elements magazine and PBA Health have followed up with their own article. Be sure to take a look here....
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Business Insider recently put out an excellent article that deserves the attention of legislators and consumers alike. After reading  Linette Lopez’s article  Companies you’ve never heard of are making a killing off high drug prices, you will better understand many of the convoluted facets of this industry....
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During my senior year in pharmacy school, one of the most important lessons drilled into me was to look at the bigger picture. As a young professional, I naturally tended to look at individual data points like lab values and then make recommendations. Generally speaking, this is a not seeing the forest for the trees......
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Recently, I was reviewing a new prescription for a patient. It was not the clinical ramifications of the newly prescribed Humolog and Lantus that caught my eye. What caught my attention was the fact that on one of the prescriptions I was making money and on the other I was losing money. At issue is the arbitrary nature of......
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The concept of Pay for Performance as it pertains to healthcare is simple: save the system money by performing and receive a financial reward. Fail to perform and you will reap the financial consequences. Some models even require a financial stake from the provider before they are allowed to participate. An entry fee, as it were. The......
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